I want to know about these drugs?

Answered by: Dr Chandra M Gulhati | Editor, MIMS, New Delhi

Q:My relative male, 49 years of age is suffering from generalised anxiety disorder and panic disorder and has been taking Paroxetine controlled release Parotin-CR 12.5 with Lonazep 0.5 mg. He took it for 6 months and discontinued it. When he went to the neurophysician, he put him on S. Citadep 10 mg with Clonotril-0.5 along with Tryptomer once daily. My specific query is whether the new medicine is superior to the tablet earlier taken and is the treatment right?
My second query is with regard to the medicines Omeprazole and Rabeprazole and Esmperazole and pantaprazole. Which is the correct medicine for GERD and non-ulcer dyspepsia because mode of action is similar to omeprazole. I feel better when I take any of the above but am back to square one when I discontinue. Kindly guide me.

A:In the absence of full details including clinical history and response to various medicines, it is not possible to comment on the aptness of initial treatment and change of therapy. Medicines are neither superior nor inferior. A medicine which is appropriate in one case need not be the correct therapy in another case. Therefore none of the three medicines mentioned by you are superior to the other two. In fact Clonotril and Lonazep are exactly same, being two brands of the same drug.
Clonazepam is actually indicated for epilepsy though sometimes it is used in Panic disorders.
One needs to consult psychiatrist for GAD and Panic disorders. Neurophysicians are supposed to deal with organic brain diseases.
All the 'prazoles' are by and large equivalent. Various molecules belong to different patent holders and the claimed superiority of one over the other is often nothing but sales talk. I think it is always better to take the least expensive which in this case is omeprazole (Brand name: Ocid). It is quite possible that you are actually suffering from H. pylori infection which is the root cause of your acidity. You may wish to consult a doctor specialising in gastro-enterology and then take one of the several courses available for eradication of H. pylori infection for permanent cure.